The role of automated insulin delivery systems in diabetes is expanding. Hybrid closed-loop systems are being used in routine clinical practice for treating people with type 1 diabetes. Encouragingly, real-world data reflects the performance and usability observed in clinical trials. We review the commercially available hybrid closed-loop systems, their distinctive features and the associated real-world data. We also consider emerging indications for closed-loop systems, including the treatment of type 2 diabetes where variability of day-to-day insulin requirements is high, and other challenging applications for this technology. We discuss issues around access and implementation of closed-loop technology, and consider the limitations of present closed-loop systems, as well as innovative approaches that are being evaluated to improve their performance.

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中文翻译：

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自动胰岛素输送技术在糖尿病中的作用

自动胰岛素输送系统在糖尿病中的作用正在扩大。混合闭环系统正在常规临床实践中用于治疗 1 型糖尿病患者。令人鼓舞的是，真实世界的数据反映了临床试验中观察到的性能和可用性。我们回顾了商用混合闭环系统、其独特的功能以及相关的真实数据。我们还考虑闭环系统的新兴适应症，包括治疗 2 型糖尿病，其中日常胰岛素需求的变化很大，以及该技术的其他具有挑战性的应用。我们讨论有关闭环技术的访问和实施的问题，并考虑当前闭环系统的局限性，以及正在评估以提高其性能的创新方法。

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